Virtual-reality headset mounted smartphone-based Indentation fundus videography

Abstract

To describe a simple and novel technique that overcomes the limitation of smartphone-based fundus photography and allows examiners to capture peripheral retinal images with indentation. Smartphone with video camera in flash-on mode was mounted on virtual-reality (VR) headset. This was combined with +28D lens and +20D lens and soft cotton bud to capture high-quality videos of peripheral fundus with indentation. Autofocus function of the camera and examiner's head movements to adjust the distance was used to obtain retinal video. The procedure is akin to indirect ophthalmoscopy. The feasibility of obtaining well-focused retinal images during indentation was checked. We could obtain good quality videos demonstrating indentation of the peripheral fundus in 10 eyes showing different pathologies such as laser marks, lattice degeneration, and pigmented lesions. VR headset-mounted smartphone-based indentation fundus videography is an innovative cost-effective technique to capture peripheral retinal images. The technique can be useful for documenting retinopathy of prematurity lesions and other situations where widefield photography is not possible.

Keywords: Fundus imaging; indentation videography; peripheral retinal imaging; smartphone.

Figure 1

(a) Representative photograph showing inventory required for smartphone-based indentation fundus videography. One can see iPhone 13 pro mounted on VR headset and remote switch for the device (black arrow). The flash of camera is on and the camera is exposed to allow capturing of videos (white arrow). (b) Representative photograph showing high-powered HD lenses of VR headset. (c) Representative photograph showing examiner holding +28D lens in dominant (right) hand and using soft cotton bud in nondominant hand for indentation. (d) Representative photograph showing smartphone in flash-on mode mounted on VR headset while the examiner is using both hands to capture fundus videos with indentation. VR: Virtual-reality

Figure 2

(a) Still photographs from smartphone videos showing both hands of the examiner being used for indentation fundus videography. (b) Still photograph from smartphone video showing laser marks over indentation (white arrow) in an infant with retinopathy of prematurity. (c) Still photograph from smartphone video showing lasered lattice nicely visible over indent (white arrow). (d) Still photograph from smartphone video showing a pigmented lesion (white arrow) over indent in peripheral retina of a 32-year-old female